🦷 More than a pizza party

Why there are still so few dental therapists, States start to enforce dental loss ratio rules

October 27, 2026

Good morning. A UK-based dental provider created a ranking of how bad different Halloween candy is for your teeth based on acidity, sugar levels, texture, and how long they last in your mouth. 

The worst offender? Fun Dip, which is highly acidic, comes with 3 teaspoons of sugar in every pack, and is also just not very good. Okay, that last part may be our editorializing, but are we wrong?

Inside this issue:

- vVardis prepares to go public
- How high-growth DSOs scale culture

⏰ Your reading time today: 6 minutes 22 seconds

🏆 Enjoy your coffee break with Word of Mouth, a dental-themed word game inspired by Wordle.

MARKETS

📉 3D Systems ($DDD) – 2.95 | -0.120 (3.91%)
📈 Align Technology ($ALGN) – 152.26 | +1.53 (1.02%)
📉 Colgate-Palmolive ($CL) – 93.10 | -0.82 (0.87%)
📈 Dentsply Sirona ($XRAY) – 9.22 | +0.31 (3.48%)
📈 Envista Holdings ($NVST) – 23.66 | +0.720 (3.14%)
📉 Henry Schein ($HSIC) – 84.51 | -0.17 (0.20%)
📉 Park Dental Partners ($PARK) – 19.39 | -1.40 (6.73%)
📈 Straumann Holding ($STMN) – CHF 97.74 | +4.22 (4.51%)

Stock data reflects market close as of the last day of trading, showing changes over the past five trading days.

THE DRILL DOWN

📈 Global dental equipment market is on track to hit $11.5 billion by 2031, up from $8.31 billion today, driven by rising disease rates and surging demand for digital imaging, CAD/CAM, and 3D printing, according to a Research and Markets report.

🗺️ The U.S. now has more than 8,000 designated dental professional shortage areas, with nearly 79 million Americans living in underserved zones and over 13,000 practitioners needed to fill the gaps, according to updated HRSA data.

🧒 Pediatric dentistry leads all specialties in growth since 2001, expanding by 126%, far outpacing orthodontics at 17% and oral surgery at 18%, as the broader dental industry has grown 25.5% over the same period, per TUSK Practice Sales' Dental Market Report Q4 2026.

🦷 Medicare dental coverage expansion legislation is set for reintroduction in the next Congress, with a new bill planned that would lift the statutory ban on Medicare covering most dental care and extend benefits to more than 24 million uninsured beneficiaries.

🪥 FDA issues a recall of over 4 million tubes of fluoride toothpaste, covering several brands including Brush Buddies kids toothpaste and Evo whitening products, with no reason for the recall publicly disclosed.

📉 Dental M&A deal volume fell 27% year over year in Q3 2026, with just 51 transactions completed, down 7% from the prior quarter, though DSOs still accounted for 30 of those deals, including 16 by PE-backed groups.

🪑 One in five dentists report hygienist positions sitting open for more than six months, with roughly a third of practices actively recruiting and the vast majority calling the search "very" or "extremely challenging.” Hygienists (desperately) wanted.

⚖️ Align Technology wins major European patent ruling against Angelalign, with a court in Paris ordering the Chinese competitor to recall and destroy infringing aligner products across 16 countries after its torque ridges feature was found to violate Align's Power Ridge patent.

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INDUSTRY

Curodont heads to Wall Street

The company behind Curodont is ready to go public, and its regulatory filing offers the closest look yet at how dental groups are buying, using, and billing for the product that promises fast, drill-free treatment of early tooth decay.

What’s happening: vVardis Holding, the Zug, Switzerland-based maker of Curodont, filed for a U.S. IPO earlier this month with plans to list on the NYSE. 

  • Renaissance Capital estimates the deal could raise $200 million, while Bloomberg has reported that the company would likely seek a valuation above the $1 billion-plus mark set during an April funding round led by Apollo.

  • Investors are betting that vVardis has significant room to grow. Its revenue in the first half of 2026 was only $28.6 million, but that was up 214% from a year earlier. And while it isn’t profitable yet, the company’s loss of $27.8 million over those six months of the year was down from its loss of $32.1 million over the same period last year. 

Why it’s happening: vVardis blockbuster product is Curodont Repair Fluoride Plus, a peptide liquid that’s designed to treat early tooth decay by carrying minerals from the patient’s saliva into a noncavitated lesion, rebuilding enamel from the inside.

  • vVardis says Curodont is a significant improvement over other early decay treatments on the market: It can be done quickly by a hygienist during a regular recall visit in five minutes or less, doesn’t require a drill, needle or anesthesia, doesn’t leave permanent stains (unlike silver diamine fluoride), and reaches between teeth.

  • According to the company’s filing, vVardis has sold Curodont to more than 20,000 of roughly U.S. general dental practices since launching in 2024, and nearly 8,500 practices placed more than one order in the four months ending June 30.

  • DSOs are the biggest Curodont buyer, accounting for 60% of sales moved through distributors in 2025 and the first half of 2026. Heartland Dental is both an investor (alongside Apollo and OrbiMed), and a major customer—a large enough buyer, in fact, that it’s flagged as a risk factor in vVardis’ IPO filing.

Why it matters: The pitch to DSOs is that Curodont allows you to generate revenue from restorative work done by hygienists during a recall visit, which vVardis argues means DSOs can bring in more revenue per hour of chair time than they would with traditional fillings.

  • Across hundreds of hygiene schedules, a per-tooth procedure that doesn’t require a dentist’s time could seriously move the needle on hygiene production.

Yes, but: For that math to work, you actually have to get paid—and the economics get complicated fast.

  • According to the company’s F-1, only eleven state Medicaid programs and nine commercial carriers offer even partial coverage of Curodont so far, and most plans still treat the code as experimental. In other words, for most patients, this is going to be an out-of-pocket expense for a product they've never heard of.

  • There's also no telling how much future restorative work you might be giving up. Some of the early lesions treated with Curodont today would have eventually turned into small fillings.

Bottom line: vVardis has reached real commercial scale, and the IPO will fund an even bigger sales push aimed squarely at dental groups. Your job is now to figure out whether there’s a business case for incorporating it into your practices’ offerings.

BUSINESS BITES

👔 Notable leadership changes: The ADA installs Thomas M. Paumier as its new president while voting Karin Irani president-elect and naming Rhett Raum as its second vice president, Sarah Sharfstein joins Southern Orthodontic Partners as COO from The Aspen Group, and Scott Hampel becomes president of dental tech company DentalXChange.

📈 Deals and de novos: Specialized Dental Partners reaches its 200th partnership, Guardian Dentistry Partners adds a practice in North Carolina, MB2 Dental adds a new California practice, and Aspen Dental opens a new Montana location.

LAST ISSUE’S POLL RESULTS

WORKPLACE

Forget the pizza party: High-growth DSOs are taking culture seriously

Office culture is about more than buying a cake for people’s birthdays and handing out Christmas bonuses (though those are nice things to do). DSOs that are successfully scaling are putting it at the heart of their growth strategy.

What’s happening: Heartland Dental announced it had grown to 2,000 supported offices last week, crediting its “doctor-led culture” as one of the major reasons it was able to reach the milestone. That’s a nice talking point, but the importance of workplace culture to scaling dental groups is also showing up elsewhere in the data. 

  • Earlier this spring, dental staffing marketplace GoTu surveyed 7,914 hygienists, assistants, and associate dentists. When asked why they left a specific practice, respondents pointed to culture more than anything else—even compensation.

Why it matters: In a labor market with so little slack, staff churn can quickly become a major bottleneck. And that’s exactly the situation in the dental industry right now—earlier this year, the ADA Health Policy Institute found that only 60% of dentists have enough hygienists on staff, and 91% of those trying to hire called it very or extremely challenging.

What you can do: A few groups have shared how they are trying to tackle retention through a focus on culture and making employees feel invested in the broader success of the organization. Each of these approaches may not be right for everyone, but all offer an insight or lesson to help build your own strategy.

  • Ask before people decide to leave. Just talking to employees can be an easy way to identify problems before they lead to staff quitting. Riccobene Associates Family Dentistry does twice-yearly stay interviews with every employee to gauge engagement and flight risk, and senior leaders visit every office twice a year to meet one-on-one with every doctor.

  • Act based on what you hear. Simply Dental Management ran two anonymous company-wide surveys, then changed how it communicates, launched an employee portal, and revised its benefits. It plans to repeat the check-in every year. Heartland Dental pairs an annual engagement survey with shorter, more frequent pulse surveys, according to its chief HR officer.

  • Give people a real stake. Mortenson Dental Partners has run an employee stock ownership plan since 2005, with ownership split between an employee trust and doctors. It says doctor retention tops 90% and hygiene retention exceeds 85%.

  • Offer clinicians autonomy over their own learning. Bright Direction Dental treats education as the center of its culture, running year-round doctor-led continuing education programs. The group says its aversion to top-down directed continuing education keeps it from turning into a compliance box-checking exercise, and more than 80% of its clinicians regularly participate in some form of ongoing learning.

  • Find what works and deploy it everywhere. Juniper Services enjoyed excellent retention among its hygienists in Nevada but saw heavy turnover after buying offices in Boise. It overhauled operations in the Boise locations to replicate what was working in Nevada, including creating a growth plan for every role, and saw retention improve.

Bottom line: One dental exec recently defined culture as “what people do when no one’s watching.” As you scale, it’s going to become more and more the case that “no one’s watching”—at least no top leaders. The groups that keep growing through this labor market will be the ones whose leaders ask the right questions, get honest answers, and have the authority to act on them.

🗳️ The Check-up:

⬆ VOTE: How would you rate the culture in your workplace?

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CLINICAL NOTES

🦷 Regular childhood dental visits are linked to better oral health outcomes in adulthood, according to a large study of nearly 4,700 individuals, which found that early-life dental attendance may shape oral health trajectories across the entire lifespan. Good habits start young.

📺 More screen time may be linked to cavities and tooth decay in children, with a study from Japan finding that toddlers who went from no regular screen time at 18 months to an hour or more daily by age three were 27% more likely to develop cavities, and those with persistent high exposure to screens had a 55% greater risk of tooth decay. Another reason to quit doomscrolling.

🧬 Smart peptides could offer a more targeted approach to treating early cavities, with a review finding that certain peptides may outperform current options, which carry limitations ranging from incomplete lesion reversal to tooth staining.

FUN AND GAMES

BEYOND THE CUSP